My nursing placement in India – Sophie Grout
As a second year Children’s nursing student I undertook a four week nursing placement in India based at Sree Gokulam Nursing College, Kerala, organised through Global Medical Projects. For my Professional Development Experience (PDE) I wanted to have the opportunity to explore nursing in a developing country rich in culture and traditions. My aim was to gain an understanding of how acute and community care of children differs between India and the UK through observing and participating in care in different health settings.
From the moment I arrived in India, all the staff and students at the Nursing College were very hospitable making me feel welcome and like one of their own students. Everyone was so friendly, happy to help, answer my numerous questions and organise a nursing placement specific to my interests and objectives. It was inspirational seeing how the professor at the college is trying to inspire passion into her students as she fights to make nursing more highly regarded, in India it is not seen as a profession.
I spent two weeks in the community with the second year student Nurses from Sree Gokulam. Every morning we explored a different aspect of community nursing in Kerala and were able to experiences healthcare in the rural areas and how the way people live has a direct influence on health. Visits included; home visits, Anganwadis (Children’s Centres), administrative centers, women’s self help groups and rural hospital with immunisation clinic. It is fantastic to see the determination that these women have to increase people’s qualities of life..it could well be said that the women of Kerela will eliminate poverty in time. With India’s aim to become a developed country by 2020 the influence that these women have is inspirational.
For my next two weeks I was based on the Paediatric ward at the Private Sree Gokulam hospital where I also got the opportunity to experience Paediatric out patients and neonatal intensive care. Although the principles were the same, intervention methods and ward routine differed. I was able to observe and participate in some basic nursing procedures becoming confident in the ward routine, admission/discharge process and help with drug and fluid administration.
Kerala is the most developed state in India and therefore the hospital was very advanced compared to many in the country. Despite this and the hospital’s large elaborate outside appearance the wards were very plain and bleak with 30 beds all packed closely together, nowhere for the family to sit and no curtains for dignity. The children lay on the beds all day with no toys or distraction and were expected to ‘rest’ while their families brought in all of their meals wrapped in newspaper. The Nurses did little in the way of distraction during procedures and I found it hard not to say anything when I was told to help hold down a screaming twelve year old along with four other nurses while blood was being taken and her mother waited anxiously outside. Despite policy being evident this was not always implemented and infection control seemed very inconsistent with the Nurses never washing their hands unless visually dirty, no sign of gloves or aprons and open access to the diarrhoea ward. Medicines and IV’s were prepared at the Nurses station and the ward was hot and stuffy with frequent power cuts. The Nursing process and interventions were much the same as in the UK. With no NHS it was sad to hear the doctors telling you that they often could not prescribe the most appropriate medicines as the people could not afford them, delaying recovery times.
In India Nurses train for four years to be general nurses of all branches, specialising at masters level. They are taught a range of modules including biochemistry, microbiology, physiology, nutrition, medical, surgical and community health nursing in the form of lessons with classes of seventy students. The students attend college Monday – Saturday 9am – 4pm with clinical/community postings in the morning and theory lessons/labs in the afternoon. The Nurses were extremely hard working and worked nine hour shifts with only four days off a month. The Nurses were very helpful and I interacted with them, exchanging nursing, cultural and personal experiences. Many of the Nurses questioned my choice for wanting to be a Nurse as Nursing had been their parents choice, one particular Nurse had desperately wanted to be a teacher. This really saddened me as there was no passion, although they said they had ‘adapted to Nursing and now enjoyed it’ and that it was a job with financial security.
Through completing this experience it has not only aided my professional but also my personal development. I was able to improve my communication and listening skills through interacting with the nurses, doctors and students. The placement was fantastic providing me with many opportunities to engage in nursing interventions while comparing the differences in healthcare, nursing training, common illnesses and nursing practice between that of the UK and India. It also improved my confidence. I had to be open minded and flexible with my time, constantly pushing myself in order to gain the most out of the opportunities available. Through observing the effects of hospitalisation on patients and how care differed between the UK and India it really reinforced the importance of dignity, patient/nurse relationships and the use of distraction and play therapy. This experience has confirmed my enthusiasm and passion for nursing and once qualified I hope to return to Sree Gokulam along with many other countries to continue my professional development.
By undertaking such a placement with Global Medical Projects I shared a home stay with other volunteers where our meals were provided. Babu Menon (in country director) was fantastic in meeting all of our needs/requests, insuring our safe travels to placement, being overall in charge of organising my placement and helping us to plan our weekends. Although you can organise your own placements direct with hospitals I would strongly recommend going through a company such as Global Medical Projects as this provides you with the security of a pre organised placement, food and accommodation. At weekends I was able to travel around Kerala with other volunteers. Weekend adventures included sightseeing, beach visits, elephant riding, exploring Trivandrum, temple visits, staying on a house boat and canoeing down the backwaters.
I am forever grateful for the great hospitality that all the staff and students both in the Nursing College and hospital showed me during my placement. I would also like to extend my thanks to the School of Health Sciences, Southampton, Global Medical Projects and all my family and friends for the support and encouragement they provided making such an experience possible.
To follow in Sophie’s footsteps, find out more about our nursing projects in India.